Monthly Archive: December 2016

Dec 20

Important 1115 Waiver (DSRIP) Updates

Please see the main notes of interest recently received from HHSC bulleted below, as well as the RHP2 Waiver Office holiday schedule*. Additional information is attached related to financial and reporting information. If you have any questions or comments, please feel free to reach out to me personally.

Waiver Renewal

  • HHSC is planning on submitting a request to CMS in the new year for an additional 21 month extension. The current extension takes us through December 31, 2017. The additional extension would take us through September 30, 2019. This will allow time for transition to the new presidential administration, and an additional Texas legislative session in spring 2019. The request would be to continue level funding for both DSRIP and UC consistent with the current 15-month extension.
  • This does not change the plans for the draft Program Funding and Mechanics (PFM) protocol in development, with a draft planned for January 2017 for stakeholder feedback. HHSC has a PFM approved for DY 6, which ends on September 30, 2017. The PFM in development for DY 7 will be developed to accommodate a DY 8, with future updates as needed.
  • Stakeholder input will occur for the draft PFM, including a webinar in February 2017.
  • In last week’s anchor notes, we said that the DY7 program rules would be proposed in February to be effective in August 2017.  We want to clarify that the HHSC internal timeline is to have rules drafted in February.  The actual date that the rules will be proposed in the Texas Register will likely be in May 2017 with an effective date in September 2017.

January 2017 Payments

  • Attached is the project level approved DSRIP amounts. The bolded columns are for the total approved amounts for each DY. Note that these are the approved DSRIP amounts while actual DSRIP payments will be based on IGT transferred.
  • As noted previously, below are the estimated payment dates:
    • January 19, 2017 – October reporting DY5 DSRIP payments processed for transferring hospitals and top 14 IGT Entities. Note that this date was previously January 13th.
    • January 31, 2017 – October reporting DY4 DSRIP payments processed for all providers and DY5 DSRIP payments processed for remaining providers that were not paid on January 19, 2016. Note that there are separate transactions for each payment for each DY.

DY6 Monitoring IGT

*As a reminder, the Anchor Office will be closed the week of December 26, 2016 for UTMB’s Winter Break. Normal operations will resume on Monday, January 2, 2017 at 8 a.m.; however, during the break, Waiver Office management will be periodically checking both e-mail and voice mail. I invite you to contact me via cell if you need anything urgently. My cell is 281-806-0347. Please do not hesitate to do so if needed.

Craig S. Kovacevich, MA
Associate Vice President
Waiver Operations & Community Health Plans
Office of the President
The University of Texas Medical Branch at Galveston
Region 2, 1115 Medicaid Waiver
University of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0985
P 409.766.4047 M 281.806.0347
F 409.747.0896 E cskovace@utmb.edu

Permanent link to this article: https://blogs.utmb.edu/1115/2016/12/20/important-1115-waiver-dsrip-updates/

Dec 20

TIME SENSITIVE INFORMATION: DY5 DSRIP IGT Notification for January 2017 Payment

Dear RHP 2:

It is very important for you or the appropriate person in your organization to review the message below from the HHSC Rate Analysis department regarding your October DY5 IGT notification.

Please see specific instruction below of where to send specific types of questions:

TXHealthcareTransformation@hhsc.state.tx.us or Rate_Analysis_DSRIP_Payments@hhsc.state.tx.us

Additionally, you can always reach out to me personally.

Thanks,
Craig S. Kovacevich, MA
Associate Vice President
Waiver Operations & Community Health Plans
Office of the President
The University of Texas Medical Branch at Galveston
Representing
UTMB Multi-Share, UTMB ChoiceONE Select and UTMB HealthCare Systems
Region 2, 1115 Medicaid Waiver
University of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0985
P 409.766.4047 M 281.806.0347
F 409.747.0896 E cskovace@utmb.edu
*******************************************************

Government Entities/Providers:

Please carefully review this message in its entirety making note of the information provided which pertains to the DY5 Delivery System Reform Incentive Payments (DSRIP). Government entities that owe monitoring will need to submit two separate transactions for monitoring and DSRIP projects. Failure to do so may result in a delayed payment for the providers. 

Attached are the following files: DSRIP Notification- DY5 Round 2 Oct 2016 Affiliation Summary and DY5 Round 2 Oct 2016 IGT Summary workbooks. These workbooks include DY5 DSRIP payments for DY5 Reporting (October), DY4 Carry Forward Reporting and DSRIP Monitoring.

The DY5 Round 2 Oct 2016 Affiliation Summary workbook has separate tabs for each Regional Healthcare Partnership (RHP) and contains the Intergovernmental Transfer (IGT) needed, by affiliation, for DY 5 DSRIP payments for DY 5 Reporting (October) and DY 4 Carryforward Reporting.

The DY5 Round 2 Oct 2016 IGT Summary workbook has separate tabs for each RHP and contains the total IGT needed by IGT Entity Name for the DY 5 DSRIP payments for DY 5 Reporting (October), DY4 Carryforward Reporting, and DSRIP Monitoring.

The Transformation Waiver Team had earlier emailed the Anchors information to share with providers regarding how much will be paid by project. Health and Human Services Commission (HHSC) Rate Analysis is unable to answer questions regarding this information.  Please send any questions regarding this information to TXHealthcareTransformation@hhsc.state.tx.us

HHSC requires separate TexNet transactions for DSRIP Monitoring IGTs and DSRIP Reporting IGTs.  The DSRIP Monitoring IGT should be placed in the Audit Cost bucket and the DSRIP Reporting IGT should be placed in the DSRIP bucket.  If the full DSRIP Monitoring IGT is not submitted in the Audit Cost bucket, HHSC will reallocate IGTs for DSRIP Reporting for DSRIP Monitoring payments.  Note that failure to submit two separate transactions or failure to IGT the full DSRIP Monitoring requirement may result in a delayed payment as additional manual steps will need to be performed.   

IGT Entities may choose to IGT less than the required amount for DSRIP Reporting payments; however, all affiliated providers and projects will be paid proportionately. IGT may not be directed towards specific providers, projects or metrics.

A screen shot/.pdf of the confirmation/trace sheet or email of the confirmation number if the TexNet is submitted over the phone is required and must be emailed to Rate_Analysis_DSRIP_Payments@hhsc.state.tx.us. We are requesting that all government entities enter their IGT transactions into TexNet no later than January 3rd with a Settlement Date of January 4thNo IGT’s submitted after January 3rd will be accepted. 

HHSC Accounting will request the Comptroller to issue payments according to the following estimated schedule (note that these dates are slightly different from what was previously posted in the October DY5 Reporting Companion Document):

  • January 3, 2017 Last Date For Public Entities to enter TexNet and submit Trace Numbers
  • January 4, 2017 TexNet Sweeps (Settlement Date of funds)
  • January 19, 2017 Payment issue date for Top 20 Entities for DY5 payments (Transferring Hospitals “Big 6”) and remaining entities. *We will not know who the other 14 entities are until the payment is processed*
  • January 31, 2017 Payment issue date for remining DSRIP Providers for DY5 and all providers for DY4

Thank you,
HHSC Hospital Rate Analysis
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78714-9030

Permanent link to this article: https://blogs.utmb.edu/1115/2016/12/20/time-sensitive-information-dy5-dsrip-igt-notification-for-january-2017-payment/

Dec 12

1115 Waiver – RHP 2 12/9/16 Anchor Notes & Reporting Results

Good afternoon Region 2:

I’ve attached the notes from Friday’s Anchor call with HHSC and highlighted a couple of important topics and deadlines for you below.

October DY5 Reporting

  • HHSC finished initial review and sent individual results to providers on Friday.  Each performing provider should have received an email Friday afternoon that summarized the findings at the metric level.
  • Results files should be reviewed carefully for any “Need More Info” or “Incomplete” signoff results.  If you have trouble interpreting the HHSC Comments or have any questions, please let me know.
  • Additional supporting documentation is due by 11:59 pm on January 17th in the Online Reporting System.
  • Failure to submit the requested materials by this deadline will result in the forfeiture of money associated with that metric.
  • IGT notifications will go out December 19th (estimated) for metrics that were initially approved for payment in January
  • Category 3: carefully review the notes regarding NMIs due to data lag. For those who opted for the planned NMI to report Category 3 and still have AM-1.1 dollars available, note that those dollars will be permanently lost if data is not submitted prior to the close of the NMI response period.

Compliance Monitoring

  • Round 3 projects have not yet been selected as HHSC and MSLC is still working to resolve Round 2 work.

Waiver Renewal – Sustainability Planning

As outlined in the Program Funding and Mechanics protocol, DY6 payments will be partially based on qualitative reporting on what DSRIP Providers are doing to ensure sustainability of project work.  The draft questions for that reporting requirement are being shared now for your feedback.    Please take some time to review the draft questions and provide your feedback or concerns back to Susan Seidensticker in the Anchor office (smseiden@utmb.edu) or  the HHSC Waiver mailbox by the January 30th deadline.  Note that these are only draft questions, but it is likely that the requirement for October DY6A reporting will be quite similar to what you see here.

There are a few additional notes regarding the longer term waiver renewal and negotiations between HHSC and CMS.  We will continue to provide you with the updates of these negotiations as they occur.

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
281.806.0347 (Cell)
409.766.4047 (Office)
cskovace@utmb.edu
Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

Permanent link to this article: https://blogs.utmb.edu/1115/2016/12/12/1115-waiver-rhp-2-12916-anchor-notes-reporting-results/

Dec 02

Important Dates for 2017 DSH and DY 6 UC

Please see the information below from HHSC regarding pertinent dates for 2017 DSH and DY 6 UC:

Providers,

The purpose of this email is to inform you of the upcoming dates that pertain to the 2017 DSH and UC programs. Below is a timeline of significant dates that all providers need to be aware of:

November 11, 2016 – Medicaid MMIS data (INRR404 Reports) became available for providers to download from the TMHP “workspace” portal. The user guide for accessing the portal as well as the webinar materials explaining the new portal and procedure for accessing the INRR404 reports are attached to this email.

November 18, 2016 – Deadline for providers to request a 2017 DSH/UC Application

January 9, 2017 – HHSC will send the applications to providers. HHSC Rate Analysis must receive a completed application no later than 30 calendar days from this date unless an extension is requested and granted.  HHSC Rate Analysis will extend this deadline provided that HHSC receives a written request for the extension to the UC tools mailbox.

In accordance with Texas Administrative Code §355.8066(e), the application will be prepopulated with certain Medicaid data and hospital cost report data.  You may request that HHSC review any data in your DSH or non-DSH application that is pre-populated by HHSC.  If you wish to appeal the data you must submit a written request for review and all supporting documentation to HHSC and TMHP within 30 days following the distribution of the pre-populated application by HHSC. The request must allege the specific data omissions or errors that, if corrected, would result in a more accurate HSL.

Starting this year (Program Year 2017), hospitals should review all of the claims and encounter data for DSH/UC 2017 and submit all claim and encounter appeals during this formal appeal period including paid, adjusted or denied claim and encounters.  Please do not wait to attempt to submit an informal claim or encounter appeal for DSH/UC 2017 data until the DSH examination or UC reconciliation by M&S.

January 10, 2017, 1:30-3:00 pm – 2017 DSH/UC Webinar for completing the application and methodology changes for 2017 DSH and DY 6 UC. Providers may register for the webinar at the following link: https://attendee.gotowebinar.com/register/6705165332820419075

January 27, 2017 – DY 6 UC Advance Payment IGT Notification

  • 12/28/16 – Deadline to submit new affiliation agreements for DY 6 advance UC payment
  • 2/2/17 – IGT Settlement Date
  • 2/28/17 (at the latest) – All providers paid

February 3, 2017 – Deadline for providers to request a 15 day extension to submit their application. Extensions are only granted for application submissions and not appeal submissions.

February 10, 2017

  • Deadline for Medicaid data appeal submissions to TMHP/HHSC.
  • Deadline for providers to request a 15 day extension to submit their application. Extensions are only granted for application submissions and not appeal submissions.
  • Application due date for providers who do not request extensions.

February 24, 2017 – Deadline for application submissions for providers who requested an extension.

  • 2/24/17 is also the IGT notification date for the 3rd 2017 DSH advance payment
  • 3/3/17 – IGT Settlement data for 3rd 2017 DSH advance payment
  • 3/31/17 (at the latest) – Providers paid for 2017 DSH advance payment

February 10 – April 14, 2017 – HHSC will correspond with providers and review/finalize applications.

April 24, 2017 – 2017 DSH qualification results sent to providers.

May 12, 2017 – 2017 Final DSH payment calculation sent to providers.

June 2017 – 2017 Final DSH Payment

  • 6/1/17- Pass 1 and 2 IGT notification
  • 6/8/17 – Pass 1 and 2 IGT settlement date
  • 6/16/17 – Pass 3 IGT notification
  • 6/20/17- Pass 3 IGT settlement date
  • 6/30/17 (at the latest) – All 2017 DSH providers paid

July 7, 2017 – UC Category 4 and Learning Collaborative certifications due to HHSC for all non-DSRIP providers who are participating in UC.

July 17, 2017 – Deadline to submit new affiliation agreements for DY 6 final UC payment.

July 26, 2017 – Final DY 6 UC payment calculation sent to providers.

August 14, 2017 – IGT commitment amounts for UC payment sent to providers.

August 21, 2017 – IGT commitment amounts due to HHSC.

September 2017 – Final DY 6 UC Payment

  • 8/25/17 – UC IGT notification
  • 9/8/17 – UC IGT settlement date
  • 9/30/17 (at the latest) – All DY 6 UC providers paid

Adherence to these dates is important in order for HHSC to make payments in accordance with the payment schedule agreed upon with stakeholders.

Please be aware that you will receive correspondence from HHSC on or around the dates listed in the timeline. If you have any questions, please contact the UC tools mailbox at uctools@hhsc.state.tx.us.

Thank You,
Mance Fine
Rate Analyst
Texas Health and Human Services Commission
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78751
Tel:  512-462-6386
Mance.Fine@hhsc.state.tx.us

Permanent link to this article: https://blogs.utmb.edu/1115/2016/12/02/important-dates-for-2017-dsh-and-dy-6-uc/